초록접수 현황
| 20F-052 | 구연 발표 |
Operative outcomes of local consolidation with cytoreductive surgery for oncogenic-driven advanced NSCLC
Byung Jo Park1, Seong Yong Park1, Min Hee Hong2, Young Ho Yang1, Ha Eun Kim1, Chang Young Lee1, Jin Gu Lee1, Dae Joon Kim1, Hyo Chae Paik1, Kyoung Young Chung1
1 Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : The local consolidative therapy with targeted therapy has been studied recently, but these studies mainly focused on radiation therapy, and the role of surgery has not been studied yet. This retrospective study was performed to investigate the operative outcomes for oncogenic-driven advanced NSCLC after targeted therapy as a form of local consolidation.
Methods : Between March 2018 and July 2020, 44 patients received the pulmonary resection and mediastinal lymph node dissection for stage IIIB-C or IV NSCLC after targeted therapy. The operative outcomes were analyzed retrospectively.
Results : The median age of patients was 59 years-old(range, 28~75), with 15(34.1%) male patients. The initial stages were as following; 4 IIIBs, 1 IIIC, and 39 IVs. The initial mutations were 30 EGFRs, 8 ALKs, and 1 ROS1. The median interval from the initiation of targeted therapy to the operation was 10.7(range, 2.1~46.3) months. The types of operations were as follows; 37 lobectomies, 2 bi-lobectomies, and 5 sub-lobar resections. The complete resection was achieved in 40(90.9%) patients. There was no operative mortality. Four patients showed complete remission on the surgical specimen. Among 32 patients with EGFR mutation, 12 patients showed additional mutations, such as T790M, and targeted agents were changed into another targeted agent in 9 patients after the operation.
Conclusion : The pulmonary resection for advanced NSCLC after targeted therapy was feasible, and the surgical specimen obtained from the operation could be used for further planning of targeted therapy. The long-term benefits of pulmonary resection on survival after targeted therapy have to be studied in further trials.
Methods : Between March 2018 and July 2020, 44 patients received the pulmonary resection and mediastinal lymph node dissection for stage IIIB-C or IV NSCLC after targeted therapy. The operative outcomes were analyzed retrospectively.
Results : The median age of patients was 59 years-old(range, 28~75), with 15(34.1%) male patients. The initial stages were as following; 4 IIIBs, 1 IIIC, and 39 IVs. The initial mutations were 30 EGFRs, 8 ALKs, and 1 ROS1. The median interval from the initiation of targeted therapy to the operation was 10.7(range, 2.1~46.3) months. The types of operations were as follows; 37 lobectomies, 2 bi-lobectomies, and 5 sub-lobar resections. The complete resection was achieved in 40(90.9%) patients. There was no operative mortality. Four patients showed complete remission on the surgical specimen. Among 32 patients with EGFR mutation, 12 patients showed additional mutations, such as T790M, and targeted agents were changed into another targeted agent in 9 patients after the operation.
Conclusion : The pulmonary resection for advanced NSCLC after targeted therapy was feasible, and the surgical specimen obtained from the operation could be used for further planning of targeted therapy. The long-term benefits of pulmonary resection on survival after targeted therapy have to be studied in further trials.
책임저자: Seong Yong Park
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Byung Jo Park, E-mail : BZPARK@yuhs.ac